Hey, I keep hearing about Medicare Advantage plans everywhere. What's the real deal with those compared to regular Medicare?

Question

Lt Col Tim Brown · Accepted Answer

There are two types of plans that go with medicare. A Medicare Supplement plan and a medicare Advantage plan. Medicare Advantage comes with dental, vision, hearing and a drug card. They are co pay driven. Example is primary care doctor no co pay, specialists (depending on the plan) you pay $15 to $50 for a visit. They come with other benefits too.

Answered by Lt Col Tim Brown on April 8, 2025

Broker Licensed in TN, AL, CO & 10 other states

Answered by Lt Col Tim Brown Medicare Insurance Agent

William Lawler · Answer

Original Medicare (OM) is a government administered 80/20 health plan. An Advantage plan covers some of the costs not covered by OM plus prescription drug, vision, dental and hearing coverage. Advantage plans are available at low or no monthly premium.

Answered by William Lawler on April 7, 2025

Broker Licensed in MO, FL, IA & 12 other states

Answered by William Lawler Medicare Insurance Agent

Justin Lucas · Answer

MAPD give you a stop loss. Depending on the plans you may receive extra stuff like Dental, Vision, Hearing.

John L Herman Jr · Answer

MEDICARE ADVANTAGE PLANS have additional coverage including DENTAL / HEARING / VISION and PDP (PRESCRIPTION DRUG PLANS). You should consult with a local Independent Boker to see which Plans and which options are available to you.

Answered by John L Herman Jr on April 16, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent

Gary Henderson · Answer

This is a long story, but in short, if you get a Medicare supplement plan, you have much better coverage. You're covered at 100% in the hospital. You're covered at 100% outside the hospital after you pay your annual deductible for that 
Medicare advantage plans are similar to what you had working. They look very familiar in terms of the coverage the government gives them your part b payment which this year is $185 so they offer it to you for free 
They have the same limitations that you had before with doctors, hospitals and coverages off an expensive coverages like cancer are not covered as well 
So if you can afford it, get a Medicare supplement plan. If you need assistance understanding all your options give me a call

Mike Henry · Answer

Their Dr s. Their hospitals. Everything has to be a referral. Zip code controls. May or may not cover some testing or drive a long way for one. If you have limited income might be your best option

Barbara Barnes, CMIP® · Answer

That is a full 1+ hour discussion. Reach out and I’m happy to discuss it with you. For now, please know that they are real and they work well for some people, but you do take more medical risk with them for a variety of reasons.

Answered by Barbara Barnes, CMIP® on April 13, 2025

Agent Licensed in PA

Answered by Barbara Barnes, CMIP® Medicare Insurance Agent

Louanne Allison · Answer

Original Medicare pays 80% for your medical needs, leaving you with a 20% copay on all doctor visits, tests, and more. Medicare Advantage plans are designed to cover the 20% with specific dollar copays to the consumer. For example, a specialist may charge $300 for a visit, and if the person has just Medicare, their copay is 20% of $300 or $60. With a Medicare Advantage plan, the copay for a specialist runs between $0-$50, depending on the plan. Medicare Advantage plans often include dental, vision, hearing, free over-the-counter items, transportation and more.

Answered by Louanne Allison on April 28, 2025

Agent Licensed in MI, FL, IL & OH, TN, TX & UT

Answered by Louanne Allison Medicare Insurance Agent

Alexander Lehn · Answer

This is a hard question to answer without the opportunity to sit down with you for a presentation, but I'll give you my best breakdown. Original Medicare covers 80% of most of your healthcare costs and it carries a few different deductibles and out of pocket costs. You are required to maintain prescription drug coverage while on original Medicare and you are responsible for the 20% cost share on any approved services. Medicare does not include preventative care and requires all services to be "Medically Necessary" i.e. routine bloodwork would not be covered but if you had kidney failure and needed blood labs done, they would cover that.

In comparison, Medicare Advantage plans are more like traditional health insurance. They have a network of Doctors and Hospitals they work with and require you to use. They may have copays but they include preventative care and can offer supplemental benefits. These are the plans that people talk about which may include dental, vision, hearing, or other benefits that original Medicare doesn't. These plans can have as low as a $0 monthly premium and most of them include prescription drug coverage.

Choosing between the two requires an in-depth look at your individual health, financial situation and lifestyle preferences. If you travel a lot, staying on original Medicare and purchasing a Supplement plan may be best for the flexibility of no mandated network. If you stay close to home and prefer having some supplemental benefits or are lower income and need a $0 monthly premium, the Advantage plan may be a great option. It comes down to talking with a licensed agent who can understand your needs to provide the right options so you can make an informed decision.

Taylor Blankenship · Answer

Regular or “Original Medicare” only cover part A- Hospital and part B-Medical 
Usually with Original Medicare you have to add on a drug plan and that means you will have a few different premiums. Original Medicare also does not include an Out Of Pocket Maximum… So you take on a bunch of risk if you was to ever have an extended stay or a high Hospital bill. 

Medicare Advantage plans make things a lot simpler, like combining your Hospital, Medical and Drug coverage all in one. With one premium payment, some Medicare Advantage plans also have a $0.00 premium and these plans usually have built in perks like Dental, Silver Sneakers/ Gym membership, Over the counter benefits and more. Plus there are a ton of plans to choose from with all different and trusted carriers, make sure you have an agent that can go over the details of the plan and make sure your doctors and medications are covered.

Todd Poe · Answer

Medicare Advantage has lower out of pocket maximum
Can include dental, vision, hearing and other benefits that Orig Medicare does NOT have
Typically Medicare Advantage can save you money on precriptions.  Original Medicare does NOT cover medications.

Hey, I keep hearing about Medicare Advantage plans everywhere. What's the real deal with those compared to regular Medicare?

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Hey, I keep hearing about Medicare Advantage plans everywhere. What's the real deal with those compared to regular Medicare?

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